大动脉瘤螺旋CT血管造影与DSA比较研究

目的:探讨大动脉瘤螺旋CT 血管造影(SCTA) 检查技术和应用价值,为合理选择SCTA 和DSA 检查方法提供依据。材料和方法:34 例大动脉瘤,均行SCTA 和DSA 检查,其中29 例经手术证实,术后7 例随访检查用SCTA。SCTA用最大强度投影( MIP) 和表面遮盖显示(SSD) 两种方法重建血管。结果:胸主动瘤10 例,腹主动脉瘤15 例,胸腹主动脉连续性动脉瘤2 例,髂动脉瘤7 例。SCTA 和DSA 均能较好地显示大动脉瘤的部位、形状、范围及夹层情况。MIP 重建图像能显示动脉壁钙化,SSD 重建图像能较好地显示动脉瘤的三维形态,SCTA 结合CT 横断面及多平面重建图像可更清楚显示动脉腔、动脉壁、附壁血栓及动脉周围组织结构。DSA 图像空间分辨力较SCTA 高,但不能清楚显示动脉壁、附壁血栓及动脉周围组织结构。结论:对大动脉瘤可首选SCTA 检查以替代DSA 检查。

Comparative Study of SCTA and DSA for Large Artery Aneurysms

Purpose: To optimize spiral CT angiography (SCTA) technique, to evaluate value of SCTA application and give more informations about how to select SCTA or DSA for large aneurysms reasonably. Materials and Methods: Thirty four patients with large artery aneurysms underwent both SCTA and DSA examinations. twenty nine cases were documented by operation with 7 cases followed up by SCTA after operation. MIP and SSD reconstruction were used for SCTA. Results: There were 10 cases with thoracic aortic aneurysm, 15 cases with abdominal aortic aneurysm, 2 cases with consecutive aneurysm form thoracic to abdominal aorta. Both SCTA and DSA could display the site, shape, extent and dissecting pseudocoele of large artery aneurysms well. The image of MIP reconstruction could display calcification of artery wall, but SSD could display the 3D shape of aneurysm well. Also, SCTA combined with CT transverse and multiplane reconstruction images could clearly display the lumen, wall, thrombosis and adjacent tissues of aneurysm. Spatial resolution of DSA was superior to SCTA, but couldn't clearly display the wall, thrombosis and adjacent tissues of aneurysm. Conclusion: SCTA can be alternative to DSA for large artery aneurysms.